How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $64.57 Median $3,090.30 Typical High $14,454.40 | Facility | None | $64.57 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $9,772.37 | Professional | None | $64.57 | $64.57 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $15,848.93 Typical High $22,908.68 | Facility | None | $10,964.78 | $15,848.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $19,054.61 Typical High $22,387.21 | Professional | None | $2,454.71 | $19,054.61 | $22,387.21 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $8,317.64 Typical High $16,595.87 | Facility | None | $1,318.26 | $8,317.64 | $16,595.87 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $2,041.74 Typical High $4,897.79 | Professional | None | $1,047.13 | $2,041.74 | $4,897.79 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $4,897.79 | Professional | 52 · Reduced service | $32.36 | $32.36 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $1,949.84 | Professional | 53 · Discontinued | $12.88 | $12.88 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $7,413.10 | Professional | 54 · Surgery only | $48.98 | $48.98 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $1,479.11 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 56 · Pre-op care only | $977.24 | $977.24 | $977.24 |
Where Wisconsin sits
The same service costs 50.1 times more in Oklahoma than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 2nd of 51
$4,677
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.